{"reporting_entity_name":"Healthfirst Insurance Company","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-06-24","version":"2.0.0","provider_references":[{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003858390],"tin":{"type":"npi","value":"1003858390"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003923434],"tin":{"type":"npi","value":"1003923434"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013389089],"tin":{"type":"npi","value":"1013389089"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013924372],"tin":{"type":"npi","value":"1013924372"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013985399],"tin":{"type":"npi","value":"1013985399"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013998426],"tin":{"type":"npi","value":"1013998426"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1023172921],"tin":{"type":"npi","value":"1023172921"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033107743],"tin":{"type":"npi","value":"1033107743"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033124961],"tin":{"type":"npi","value":"1033124961"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033186093],"tin":{"type":"npi","value":"1033186093"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033270699],"tin":{"type":"npi","value":"1033270699"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043224355],"tin":{"type":"npi","value":"1043224355"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043267727],"tin":{"type":"npi","value":"1043267727"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043279565],"tin":{"type":"npi","value":"1043279565"}}]},{"provider_group_id":16,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043394745],"tin":{"type":"npi","value":"1043394745"}}]},{"provider_group_id":17,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043455199],"tin":{"type":"npi","value":"1043455199"}}]},{"provider_group_id":18,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053354100],"tin":{"type":"npi","value":"1053354100"}}]},{"provider_group_id":19,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053441907],"tin":{"type":"npi","value":"1053441907"}}]},{"provider_group_id":20,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053721563],"tin":{"type":"npi","value":"1053721563"}}]},{"provider_group_id":21,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063426377],"tin":{"type":"npi","value":"1063426377"}}]},{"provider_group_id":22,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063498889],"tin":{"type":"npi","value":"1063498889"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063525442],"tin":{"type":"npi","value":"1063525442"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063657963],"tin":{"type":"npi","value":"1063657963"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063853869],"tin":{"type":"npi","value":"1063853869"}}]},{"provider_group_id":26,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073535027],"tin":{"type":"npi","value":"1073535027"}}]},{"provider_group_id":27,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073569331],"tin":{"type":"npi","value":"1073569331"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073670519],"tin":{"type":"npi","value":"1073670519"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083605661],"tin":{"type":"npi","value":"1083605661"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215911946],"tin":{"type":"npi","value":"1215911946"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1215917224],"tin":{"type":"npi","value":"1215917224"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225083074],"tin":{"type":"npi","value":"1225083074"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225097652],"tin":{"type":"npi","value":"1225097652"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225295512],"tin":{"type":"npi","value":"1225295512"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225357452],"tin":{"type":"npi","value":"1225357452"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1225441710],"tin":{"type":"npi","value":"1225441710"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1235142472],"tin":{"type":"npi","value":"1235142472"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1235184649],"tin":{"type":"npi","value":"1235184649"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245248939],"tin":{"type":"npi","value":"1245248939"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245251222],"tin":{"type":"npi","value":"1245251222"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245299726],"tin":{"type":"npi","value":"1245299726"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245365196],"tin":{"type":"npi","value":"1245365196"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1245370717],"tin":{"type":"npi","value":"1245370717"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255360517],"tin":{"type":"npi","value":"1255360517"}}]},{"provider_group_id":16,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255498796],"tin":{"type":"npi","value":"1255498796"}}]},{"provider_group_id":17,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1255639043],"tin":{"type":"npi","value":"1255639043"}}]},{"provider_group_id":18,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275553521],"tin":{"type":"npi","value":"1275553521"}}]},{"provider_group_id":19,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275697187],"tin":{"type":"npi","value":"1275697187"}}]},{"provider_group_id":20,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275782039],"tin":{"type":"npi","value":"1275782039"}}]},{"provider_group_id":21,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1275974974],"tin":{"type":"npi","value":"1275974974"}}]},{"provider_group_id":22,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285641514],"tin":{"type":"npi","value":"1285641514"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285717298],"tin":{"type":"npi","value":"1285717298"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1285799700],"tin":{"type":"npi","value":"1285799700"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1295742468],"tin":{"type":"npi","value":"1295742468"}}]},{"provider_group_id":26,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1295743060],"tin":{"type":"npi","value":"1295743060"}}]},{"provider_group_id":27,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1306190558],"tin":{"type":"npi","value":"1306190558"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1306930318],"tin":{"type":"npi","value":"1306930318"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326046467],"tin":{"type":"npi","value":"1326046467"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477617645],"tin":{"type":"npi","value":"1477617645"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477640258],"tin":{"type":"npi","value":"1477640258"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1477798189],"tin":{"type":"npi","value":"1477798189"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1487644993],"tin":{"type":"npi","value":"1487644993"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1497701106],"tin":{"type":"npi","value":"1497701106"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1497961205],"tin":{"type":"npi","value":"1497961205"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508001405],"tin":{"type":"npi","value":"1508001405"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508815333],"tin":{"type":"npi","value":"1508815333"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1508845322],"tin":{"type":"npi","value":"1508845322"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1518061928],"tin":{"type":"npi","value":"1518061928"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1518998699],"tin":{"type":"npi","value":"1518998699"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528024718],"tin":{"type":"npi","value":"1528024718"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528125069],"tin":{"type":"npi","value":"1528125069"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528133147],"tin":{"type":"npi","value":"1528133147"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528161916],"tin":{"type":"npi","value":"1528161916"}}]},{"provider_group_id":16,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528292596],"tin":{"type":"npi","value":"1528292596"}}]},{"provider_group_id":17,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1528428521],"tin":{"type":"npi","value":"1528428521"}}]},{"provider_group_id":18,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1538173372],"tin":{"type":"npi","value":"1538173372"}}]},{"provider_group_id":19,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548315401],"tin":{"type":"npi","value":"1548315401"}}]},{"provider_group_id":20,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548367873],"tin":{"type":"npi","value":"1548367873"}}]},{"provider_group_id":21,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1548597198],"tin":{"type":"npi","value":"1548597198"}}]},{"provider_group_id":22,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568459204],"tin":{"type":"npi","value":"1568459204"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568526739],"tin":{"type":"npi","value":"1568526739"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568548782],"tin":{"type":"npi","value":"1568548782"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1568601342],"tin":{"type":"npi","value":"1568601342"}}]},{"provider_group_id":26,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578526695],"tin":{"type":"npi","value":"1578526695"}}]},{"provider_group_id":27,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578529954],"tin":{"type":"npi","value":"1578529954"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578554630],"tin":{"type":"npi","value":"1578554630"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1578664470],"tin":{"type":"npi","value":"1578664470"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740233899],"tin":{"type":"npi","value":"1740233899"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740287531],"tin":{"type":"npi","value":"1740287531"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740337971],"tin":{"type":"npi","value":"1740337971"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740344910],"tin":{"type":"npi","value":"1740344910"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1740389154],"tin":{"type":"npi","value":"1740389154"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1750737565],"tin":{"type":"npi","value":"1750737565"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1760421713],"tin":{"type":"npi","value":"1760421713"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770502635],"tin":{"type":"npi","value":"1770502635"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770573222],"tin":{"type":"npi","value":"1770573222"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770593956],"tin":{"type":"npi","value":"1770593956"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770598104],"tin":{"type":"npi","value":"1770598104"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770671182],"tin":{"type":"npi","value":"1770671182"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770890410],"tin":{"type":"npi","value":"1770890410"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1770924474],"tin":{"type":"npi","value":"1770924474"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1780600577],"tin":{"type":"npi","value":"1780600577"}}]},{"provider_group_id":16,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1790727543],"tin":{"type":"npi","value":"1790727543"}}]},{"provider_group_id":17,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801803903],"tin":{"type":"npi","value":"1801803903"}}]},{"provider_group_id":18,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801804364],"tin":{"type":"npi","value":"1801804364"}}]},{"provider_group_id":19,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801857172],"tin":{"type":"npi","value":"1801857172"}}]},{"provider_group_id":20,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1801992631],"tin":{"type":"npi","value":"1801992631"}}]},{"provider_group_id":21,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811054034],"tin":{"type":"npi","value":"1811054034"}}]},{"provider_group_id":22,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811240039],"tin":{"type":"npi","value":"1811240039"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811338288],"tin":{"type":"npi","value":"1811338288"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1811977796],"tin":{"type":"npi","value":"1811977796"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1821163718],"tin":{"type":"npi","value":"1821163718"}}]},{"provider_group_id":26,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1821394016],"tin":{"type":"npi","value":"1821394016"}}]},{"provider_group_id":27,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831229780],"tin":{"type":"npi","value":"1831229780"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831253004],"tin":{"type":"npi","value":"1831253004"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1831515154],"tin":{"type":"npi","value":"1831515154"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982771325],"tin":{"type":"npi","value":"1982771325"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992131320],"tin":{"type":"npi","value":"1992131320"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992713564],"tin":{"type":"npi","value":"1992713564"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043267727],"tin":{"type":"npi","value":"1043267727"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013071281],"tin":{"type":"npi","value":"1013071281"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043394745],"tin":{"type":"npi","value":"1043394745"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083605661],"tin":{"type":"npi","value":"1083605661"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1871606764],"tin":{"type":"npi","value":"1871606764"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962422733],"tin":{"type":"npi","value":"1962422733"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932182599],"tin":{"type":"npi","value":"1932182599"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003923434],"tin":{"type":"npi","value":"1003923434"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013985399],"tin":{"type":"npi","value":"1013985399"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013998426],"tin":{"type":"npi","value":"1013998426"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003858390],"tin":{"type":"npi","value":"1003858390"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174620629],"tin":{"type":"npi","value":"1174620629"}}]},{"provider_group_id":16,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033107743],"tin":{"type":"npi","value":"1033107743"}}]},{"provider_group_id":17,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184717837],"tin":{"type":"npi","value":"1184717837"}}]},{"provider_group_id":18,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598713745],"tin":{"type":"npi","value":"1598713745"}}]},{"provider_group_id":19,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":20,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033270699],"tin":{"type":"npi","value":"1033270699"}}]},{"provider_group_id":21,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013389089],"tin":{"type":"npi","value":"1013389089"}}]},{"provider_group_id":22,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013924372],"tin":{"type":"npi","value":"1013924372"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1023172921],"tin":{"type":"npi","value":"1023172921"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033124961],"tin":{"type":"npi","value":"1033124961"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053354100],"tin":{"type":"npi","value":"1053354100"}}]},{"provider_group_id":26,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033186093],"tin":{"type":"npi","value":"1033186093"}}]},{"provider_group_id":27,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043224355],"tin":{"type":"npi","value":"1043224355"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1063498889],"tin":{"type":"npi","value":"1063498889"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1053721563],"tin":{"type":"npi","value":"1053721563"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1952476988],"tin":{"type":"npi","value":"1952476988"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962408203],"tin":{"type":"npi","value":"1962408203"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962422733],"tin":{"type":"npi","value":"1962422733"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972523348],"tin":{"type":"npi","value":"1972523348"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972548568],"tin":{"type":"npi","value":"1972548568"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972557379],"tin":{"type":"npi","value":"1972557379"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982600680],"tin":{"type":"npi","value":"1982600680"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982611190],"tin":{"type":"npi","value":"1982611190"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982625661],"tin":{"type":"npi","value":"1982625661"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982663423],"tin":{"type":"npi","value":"1982663423"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982737136],"tin":{"type":"npi","value":"1982737136"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982761425],"tin":{"type":"npi","value":"1982761425"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982771325],"tin":{"type":"npi","value":"1982771325"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992131320],"tin":{"type":"npi","value":"1992131320"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992713564],"tin":{"type":"npi","value":"1992713564"}}]},{"provider_group_id":16,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043267727],"tin":{"type":"npi","value":"1043267727"}}]},{"provider_group_id":17,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013071281],"tin":{"type":"npi","value":"1013071281"}}]},{"provider_group_id":18,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043394745],"tin":{"type":"npi","value":"1043394745"}}]},{"provider_group_id":19,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1083605661],"tin":{"type":"npi","value":"1083605661"}}]},{"provider_group_id":20,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1871606764],"tin":{"type":"npi","value":"1871606764"}}]},{"provider_group_id":21,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1932182599],"tin":{"type":"npi","value":"1932182599"}}]},{"provider_group_id":22,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003923434],"tin":{"type":"npi","value":"1003923434"}}]},{"provider_group_id":23,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013985399],"tin":{"type":"npi","value":"1013985399"}}]},{"provider_group_id":24,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013998426],"tin":{"type":"npi","value":"1013998426"}}]},{"provider_group_id":25,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003858390],"tin":{"type":"npi","value":"1003858390"}}]},{"provider_group_id":26,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1174620629],"tin":{"type":"npi","value":"1174620629"}}]},{"provider_group_id":27,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1033107743],"tin":{"type":"npi","value":"1033107743"}}]},{"provider_group_id":28,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184717837],"tin":{"type":"npi","value":"1184717837"}}]},{"provider_group_id":29,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1598713745],"tin":{"type":"npi","value":"1598713745"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0485","name":"Oral device/appliance prefab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6503","name":"Compres burngarment facehood","description":"Compression burn garment, facial hood, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2767.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3125.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1231","name":"Rigid ped w/c tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4700.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KC"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5421.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6245.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3686.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6375.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2666.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5200.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17636.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8556.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4252.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4638","name":"Repl batt pulse gen sys","description":"Replacement battery for patient-owned ear pulse generator, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU","AV"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6504","name":"Cmprsburngarment glove-wrist","description":"Compression burn garment, glove to wrist, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2655.31,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2999.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7698.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9214.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3473.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2060.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5393.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10859.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4675.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2174.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13849.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4423.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3679.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16269.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3692.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2199.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7053.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5847.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8046.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4985.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5041.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2900.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9689.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8162.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7599.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6417.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4845.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10501.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16745.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9753.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1001","name":"Ctlso infant immobilizer","description":"Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4726.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6957.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9756.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12603.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10663.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3880.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AU","AV"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2787.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2380.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2593.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3768.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7484.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1009","name":"Add mech leg elevation","description":"Wheelchair accessory, addition to power seating system, mechanically linked leg elevation system, including pushrod and leg rest, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9441.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5417.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4944.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3230.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14025.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7499.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5853.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4581.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3939.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2685.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2093.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2027.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6188.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11738.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6510","name":"Compres burn garment leotard","description":"Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6501","name":"Compres burngarment bodysuit","description":"Compression burn garment, bodysuit (head to foot), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6544.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1965.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8523.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8017.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2111.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2951.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0008","name":"Cstm manual wheelchair/base","description":"Custom manual wheelchair/base","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12957.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1018","name":"Hd shck absrber for hd powwc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty power wheelchair, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8484.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1730.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2512.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4260.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2372","name":"Gr27 non-sealed leadacid","description":"Power wheelchair accessory, group 27 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1733.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2336.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4721.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5575.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3145.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2186.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14858.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4295.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3495.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4567.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3714.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2424.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2876.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12964.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6135.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3566.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6508","name":"Cmprs burngarment foot-thigh","description":"Compression burn garment, foot to thigh length, custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2437.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2605.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2007.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8161.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2402.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9138.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13962.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6908.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KF"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2908.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2512","name":"Sgd accessory, mounting sys","description":"Accessory for speech generating device, mounting system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14286.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9835.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12809.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5793.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6509","name":"Compres burn garment jacket","description":"Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3840.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2833.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1295.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15377.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12315.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1535.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4705.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2164.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7888.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2852.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4477.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1011","name":"Ped wc modify width adjustm","description":"Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair)","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4983.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5332.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4848.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10374.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4843.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3999.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10746.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7021.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3956","name":"Add joint upper ext orthosis","description":"Addition of joint to upper extremity orthosis, any material; per joint","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6856.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17059.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11794.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11013.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2631.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5517.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3804.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KF"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8822.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12922.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16507.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3963.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6506","name":"Cmprsburngrmnt glove-axilla","description":"Compression burn garment, glove to axilla, custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20000.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6505","name":"Cmprsburngarment glove-elbow","description":"Compression burn garment, glove to elbow, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2860.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4283.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13749.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4611.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5550.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1333.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6513","name":"Compress burn mask face/neck","description":"Compression burn mask, face and/or neck, plastic or equal, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KC","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3683.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7272.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5347.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5169.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3696.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3422.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6087.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5685.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6507","name":"Cmprs burngarment foot-knee","description":"Compression burn garment, foot to knee length, custom fabricated","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2941.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KM","KN"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10198.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4545.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.28,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.99,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2511","name":"Sgd sftwre prgrm for pc/pda","description":"Speech generating software program, for personal computer or personal digital assistant","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KF"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3333.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KL","NU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4312.49,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13771.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6096.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0486","name":"Oral device/appliance cusfab","description":"Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.27,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8004","name":"Repl soft interface, helmet","description":"Soft interface for helmet, replacement only","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2644.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5725.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KC","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12796.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1786.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1017","name":"Hd shck absrbr for hd man wc","description":"Heavy duty shock absorber for heavy duty or extra heavy duty manual wheelchair, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2786","name":"Occupational multifocal lens","description":"Specialty occupational multifocal lens, per lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6316.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0013","name":"Custom power whlchr base","description":"Custom motorized/power wheelchair base","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3427.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9603.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3496.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7744.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6632.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10468.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7320.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6810.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3119.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8532.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.96,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"Sup/ext non-ins inf pump syr","description":"Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.07,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","RR"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4147.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4405.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15196.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4484.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1886.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6826.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-16","zip":"11040","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4120.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1102.92,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3068.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["AW","AV","AU"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17168.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-16","zip":"13421","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.7,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-16","zip":"14437","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-16","zip":"14850","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[13]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3763.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3953.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3618.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-16","zip":"13502","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","cbsa":"27060","date_of_service":"2026-05-16","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-16","zip":"10550","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7746.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","cbsa":"46540","date_of_service":"2026-05-16","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[28]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6693.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","cbsa":"24020","date_of_service":"2026-05-16","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[20]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-16","zip":"10035","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","cbsa":"13780","date_of_service":"2026-05-16","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[17]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7999.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3587.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3209.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","cbsa":"33","date_of_service":"2026-05-16","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2545.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[23]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","cbsa":"21300","date_of_service":"2026-05-16","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[19]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-16","zip":"14617","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["QB","RR","QF","MS"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-16","zip":"11787","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-16","zip":"11794","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4679.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6511","name":"Compres burn garment panty","description":"Compression burn garment, lower trunk including leg openings (panty), custom fabricated","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["NU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.94,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","cbsa":"35004","date_of_service":"2026-05-16","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[24]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","cbsa":"40380","date_of_service":"2026-05-16","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3478.32,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[26]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-16","zip":"10467","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.44,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","cbsa":"48060","date_of_service":"2026-05-16","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[29]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6698.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","cbsa":"28880","date_of_service":"2026-05-16","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.82,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU"]}],"provider_references":[22]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","cbsa":"28740","date_of_service":"2026-05-16","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[21]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","KE","NU","KU"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-16","zip":"11418","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","cbsa":"45060","date_of_service":"2026-05-16","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[27]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.19,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["UE","NU","KU"]}],"provider_references":[25]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","cbsa":"35614","date_of_service":"2026-05-16","locality":"1320203","zip":"10512","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-16","zip":"10536","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["KE","RR","KU"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","cbsa":"15380","date_of_service":"2026-05-16","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2302.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["RR"]}],"provider_references":[18]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0900","name":"Cstm dme other than wheelchr","description":"Customized durable medical equipment, other than wheelchair","cbsa":"10580","date_of_service":"2026-05-16","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"]}],"provider_references":[16]}]}]}